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A look at what’s new in health insurance options

The availability of health care that is accessible and affordable is essential to our well-being. Unfortunately, health care can be expensive and the insurance system can be complex.

That’s why San Juan Basin Public Health provides information and enrollment assistance for both private health insurance through Connect for Health Colorado and public health insurance programs like Medicaid and CHP+.

SJBPH’s Health Literacy Program strives to provide information and support regarding health insurance options for regional residents. The first step we take is to make sure you have accurate, unbiased information about our health insurance system, including any recent changes and updates, some of which are great news.

The last year has generated significant discussion about health insurance issues and the Affordable Care Act (sometimes called “Obamacare”), which went into effect in 2013. Several options were proposed in Congress, including eliminating the ACA without a replacement, overhauling the health insurance system entirely or making some changes to the current law to make it more palatable to its opponents.

What changed? Thankfully, the short answer for most people is “not much.” The ACA remains mostly intact: Private health insurance is still available without regard to pre-existing conditions; significant financial help is still available for the majority of Coloradans; and SJBPH is still providing answers to your questions as well as help with the application process.

There are a few changes to the health insurance environment that should be noted, though. First, rates for most plans will stay about the same for most people who qualify for assistance. However, because the amount of financial assistance will go up this year, the most basic “Bronze level” plans may become less expensive for many folks and the more comprehensive coverage from “Gold level” plans may be a more cost-effective choice for current “Silver level” policy-holders. This is great news!

Additionally, although the ACA still contains a legal requirement to have qualified health insurance, tax regulations have been changed to reduce the penalty to zero for tax year 2019. People who make too much money to qualify for financial help through Connect for Health Colorado will have some less-expensive options through Connect for Health. That’s good news, too. Also, these individuals can now choose health insurance from another source and not pay a tax penalty. However, SJBPH is encouraging these folks to shop carefully because plans from sources other than Connect for Health Colorado can have significantly limited coverage, higher risk of out-of-pocket expenses and are not required to accept you if you have pre-existing conditions.

Although federal regulations around short-term insurance have been loosened, state law has not. In Colorado, short-term insurance lasts only three months, which can work for brief periods when other insurance is not available, such as during the waiting period before starting insurance from a new employer. However, if your short-term policy ends, you cannot get insurance through Connect for Health until the next January.

Federal regulations have also been relaxed to allow certain people to form groups in order to get less expensive health insurance, referred to as Association Health Plans. Currently, none of these plans is being offered locally. The same cautions apply to these Association Health Plans as other non-Connect for Health plans; they usually do not cover pre-existing conditions, they may have limited provider networks and they may put people at greater financial risk.

Enrollment in health insurance through Connect for Health Colorado will be open from Nov. 1 through Jan. 15. This is a longer enrollment period than the federal enrollment period, which ends Dec. 15.

If you still have questions about our health insurance system, call me at SJBPH at 335-2021. I will be holding meetings at 6 p.m. Oct. 24 and Oct. 30 at the Durango Public Library, 1900 East Third Ave.

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